All of the following are true about malignant otitis externa except:

Severe hearing loss is not the chief presenting complaint in malignant otitis externa. A patient of malignant otitis externa presents with: Severe, unrelenting, deep-seated otalgia, temporal headaches, purulent otorrhea, possibly dysphagia, hoarseness, and/ or facial nerve dysfunction. The pain is out of propoion to the physical examination findings. Marked tenderness is present in the soft tissue between the mandible ramus and mastoid tip. Granulation tissue is present at the floor of the osseo-cailiginous junction. This finding is viually pathognomonic of malignant external otitis. Rest of the options i.e. pseudomonas is the M/C cause, granulation tissue seen on superior wall of the external auditory canal and esr used for follow up are correct.